| Peter Stoops D.o. Inc | |
|
13312 Ranchero Rd Ste 16 Oak Hills CA 92344-4802 | |
| (760) 948-0132 | |
| (760) 357-0357 |
| Full Name | Peter Stoops D.o. Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13312 Ranchero Rd Ste 16, Oak Hills, California |
| Authorized Official Name and Position | Peter Stoops (CEO) |
| Authorized Official Contact | 7609480132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Stoops D.o. Inc 13312 Ranchero Rd Ste 16 Oak Hills CA 92344-4802 Ph: (760) 948-0132 | Peter Stoops D.o. Inc 13312 Ranchero Rd Ste 16 Oak Hills CA 92344-4802 Ph: (760) 948-0132 |
| NPI Number | 1851867758 |
|---|---|
| Provider Enumeration Date | 10/17/2018 |
| Last Update Date | 10/17/2018 |
| Medicare PECOS PAC ID | 7315370004 |
|---|---|
| Medicare Enrollment ID | O20191211001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851867758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Peter J Stoops |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518912526 PECOS PAC ID: 4688743958 Enrollment ID: I20080513000639 |
| Provider Name | Diana Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356807143 PECOS PAC ID: 6901291004 Enrollment ID: I20220325002234 |